Abstract
BackgroundSurgical management of cervical kyphosis in patients with NF-1 is a challenging task. Presently, anterior-only (AO), posterior-only (PO) and combined anterior-posterior (AP) spinal fusion are common surgical strategies. However, the choice of surgical strategy and application of Halo traction remain controversial. Few studies have shown and recommended posterior-only approach for cervical kyphosis correction in patients with NF-1. The aim of this study is to evaluate the safety and the effectiveness of halo Traction combined with posterior-only approach correction for treatment of cervical kyphosis with NF-1.MethodsTwenty-six patients with severe cervical kyphosis due to NF-1 were reviewed retrospectively between January 2010 and April 2018. All the cases underwent halo traction combined with posterior instrumentation and fusion surgery. Correction result, neurologic status and complications were analyzed.ResultsIn this study, cervical kyphosis Cobb angle decreased from initial 61.3 ± 19.7 degrees to postoperative 10.6 ± 3.7 degrees (P<0.01), with total correction rate of 82.7%, which consist of 45.8% from halo traction and 36.9% from surgical correction. JOA scores were improved from preoperative 13.3 ± 1.6 to postoperative 16.2 ± 0.7 (P<0.01). Neurological status was also improved. There was no correction loss and the neurological status was stable in mean 43 months follow-up. Three patients experienced minor complications and one patient underwent a second surgery.ConclusionHalo traction combined with PO approach surgery is safe and effective method for cervical kyphosis correction in patients with NF-1. A satisfied correction result, and successful bone fusion can be achieved via this procedure, even improvement of neurological deficits can also be obtained. Our study suggested that halo traction combined with PO approach surgery is another consideration for cervical kyphosis correction in patients with NF-1.
Highlights
Surgical management of cervical kyphosis in patients with NF-1 is a challenging task
Recent studies have further shown the safety and efficacy of halo traction as an operative adjunct procedure for cervical kyphosis correction.Halo traction could provide a slow and gradual correction while the patients were awake, which typically decreased the amount of corrective force that needed to be applied to the cervical spine
Our study further proved that halo traction was safe and an effective adjuvant management for cervical kyphosis correction in NF-1
Summary
Surgical management of cervical kyphosis in patients with NF-1 is a challenging task. Anterior-only (AO), posterior-only (PO) and combined anterior-posterior (AP) spinal fusion are common surgical strategies. Few studies have shown and recommended posterior-only approach for cervical kyphosis correction in patients with NF-1. The aim of this study is to evaluate the safety and the effectiveness of halo Traction combined with posterior-only approach correction for treatment of cervical kyphosis with NF-1. Anterior-only (AO), posterior-only (PO) and combined anterior-posterior (AP) spinal fusion are common strategies for the management of cervical kyphosis in patients with NF-1 [8,9,10]. Single procedure and combined therapies have been applied in the treatment of cervical kyphosis in patients with NF-1 [8, 9, 11], the choice of surgical strategy remains controversial
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